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哌替啶和氟哌利多的肌神经效应。

Myoneural effects of pethidine and droperidol.

作者信息

Boros M, Chaudhry I A, Nagashima H, Duncalf R M, Sherman E H, Foldes F F

出版信息

Br J Anaesth. 1984 Feb;56(2):195-202. doi: 10.1093/bja/56.2.195.

Abstract

In vitro experiments on the rat phrenic nerve-hemidiaphragm preparation, stimulated directly or indirectly with supramaximal impulses at 0.1 Hz revealed that pethidine in concentrations greater than 5 micrograms ml-1 caused a rapid increase of the twitch. This was maximal (60% increase during direct and 70% increase during indirect stimulation) with pethidine 75 micrograms ml-1. With concentrations of pethidine greater than 40 micrograms ml-1, the initial increase was followed by a slowly developing inhibition of the twitch (50% depression with 46.0 and 50.4 micrograms ml-1 during direct and indirect stimulation, respectively). Droperidol caused no increase in twitch, but it depressed the twitch by 50% at concentrations of 9.8 and 6.9 micrograms ml-1 during direct and indirect stimulation, respectively. The increase in twitch produced by pethidine was augmented by 4-aminopyridine and inhibited by verapamil during both direct and indirect stimulation. Tubocurarine antagonized the augmentation of the twitch by pethidine only during indirect stimulation. The pethidine- and droperidol-induced inhibition of the twitch could be reversed by washout, but it was not antagonized by neostigmine or 4-aminopyridine. The inhibitory effect of pethidine and droperidol were additive. Sub-effective inhibitory concentrations of pethidine and droperidol, and those of tubocurarine, pancuronium and suxamethonium, independently of the sequence of their administration, mutually increased the myoneural effects of one another. The resulting twitch depression could be reversed by washout. The inhibition caused by the combination of pethidine with tubocurarine or pancuronium was partially antagonized by neostigmine or 4-aminopyridine.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在大鼠膈神经 - 半膈肌标本上进行的体外实验中,以0.1赫兹的超强冲动直接或间接刺激,结果显示,浓度大于5微克/毫升的哌替啶会使抽搐迅速增加。哌替啶浓度为75微克/毫升时,这种增加达到最大值(直接刺激时增加60%,间接刺激时增加70%)。当哌替啶浓度大于40微克/毫升时,最初的增加之后会出现抽搐的缓慢抑制(直接刺激和间接刺激时,浓度分别为46.0和50.4微克/毫升时,抽搐抑制50%)。氟哌利多不会使抽搐增加,但在直接刺激和间接刺激时,浓度分别为9.8和6.9微克/毫升时,会使抽搐降低50%。在直接刺激和间接刺激过程中,4 - 氨基吡啶增强了哌替啶引起的抽搐增加,而维拉帕米则抑制了这种增加。筒箭毒碱仅在间接刺激时拮抗哌替啶引起的抽搐增强。哌替啶和氟哌利多引起的抽搐抑制可通过冲洗逆转,但新斯的明或4 - 氨基吡啶不能拮抗。哌替啶和氟哌利多的抑制作用是相加的。哌替啶、氟哌利多以及筒箭毒碱、泮库溴铵和琥珀胆碱的亚有效抑制浓度,无论给药顺序如何,都会相互增强彼此的肌神经效应。由此产生的抽搐抑制可通过冲洗逆转。哌替啶与筒箭毒碱或泮库溴铵联合引起的抑制,可被新斯的明或4 - 氨基吡啶部分拮抗。(摘要截短于250字)

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